Gender-based differences in treatment and outcome among HIV patients in South India.
OBJECTIVE
To describe gender-based differences in disease progression, treatment, and outcome among patients receiving highly active antiretroviral therapy (HAART) in South India.


METHODS
Therapy-naïve patients initiating HAART between February 1996 and June 2006 at a tertiary HIV referral center in Chennai, South India, were analyzed using the YRG CARE HIV Observational Database. Patients with 1 year of follow-up after initiating HAART were examined to investigate immunological and clinical outcomes, including the development of adverse events to therapy and opportunistic infections.


RESULTS
All previously therapy-naïve patients who initiated HAART with at least 1 year of follow-up (n = 1972) were analyzed. At enrollment into care, women had higher CD4 counts, lower hemoglobin, and higher body mass index (BMI) than their male counterparts (p < 0.05). At the time of initiating therapy, women had higher CD4 counts and lower hemoglobin (p < 0.05); women continued to have higher CD4 counts at 12 months (p < 0.05). After 1 year following HAART initiation, significantly more men developed tuberculosis and Pneumocystis jiroveci pneumonia (p < 0.05), more women experienced lactic acidosis and nausea, and more men developed immune reconstitution syndrome (p < 0.05).


CONCLUSIONS
Significant physiological, immunological, and clinical differences exist between men and women initiating HAART in a resource-limited setting in South India. Future studies should examine whether clinical management strategies should be different for men and women in resource-limited settings.
Kumarasamy
N
N
YRGCARE, VHS, Chennai, India. kumarasamy@yrgcare.org
Venkatesh
K K
KK
Cecelia
A J
AJ
Devaleenol
B
B
Saghayam
S
S
Yepthomi
T
T
Balakrishnan
P
P
Flanigan
T
T
Solomon
S
S
Mayer
K H
KH
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000382:microbiology; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015992:Body Mass Index; D018791:CD4 Lymphocyte Count; D016208:Databases, Factual; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012737:Sex Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis; D055815:Young Adult
D019380:Anti-HIV Agents